A Rare Case of Open 3A VTB2W Periprosthetic Fracture around a Total Hip Arthroplasty.

Introduction: The incidence of periprosthetic fracture (PPF) around a total hip arthroplasty (THA) continues to increase with the rise of number of THA performed. We present a rare case of a 73-year-old man who sustained an open periprosthetic femur fracture around a THA.

Case Report: This gentleman sustained an open PPF around a fully cemented THA after he lost control and fell off his bicycle. After thorough surgical debridement, internal fixation with double plating was performed and the fracture went on to unite with an excellent patient reported outcome score. To the best of our knowledge, this is the only reported open 3A VTB2W PPF THA in the literature.

Conclusion: Open PPF around a THA is a rare and uncommon occurrence. Principles of open fracture management should be continued and we recommend urgent surgery to reduce the risk of post-operative infection. Open VTB2W PPF should be fixed with double plating if the bone cement interface is intact and the fracture can be anatomically reduced. Double plating gives additional rotational stability and allows early weight bearing post-operatively.